While this is our first special section on improving relations with patients, the subject has been a particular focus of FPM throughout our five years of publication.

Confidentiality

“What Are the Limits of Patient Confidentiality?” September 1995, p. 28.

When a patient's condition has the potential to harm others, the ethical and legal considerations are difficult to resolve. When privileged information must be disclosed to prevent harm, you should warn potential victims directly, if possible.

Difficult situations

“Teaching Staff to Say ‘No’ Graciously,” September 1994, p. 84.

When a patient's request must be denied, staff members should explain why. To do so effectively, they must understand the reasons behind your policies.

Although some patients' requests and complaints may seem unreasonable, you and your staff should do all you can to make patients feel they're receiving excellent customer service, even when they don't get their way.

E-mail and web sites

You can use the World Wide Web and e-mail to communicate with patients in a more timely fashion and to strengthen their sense of being connected with you and your practice.

Office visits

“Off to the Right Start,” October 1993, p. 16.

Start your physician-patient relationships on the right foot by asking questions like these: Who has been your family doctor? Why did you leave that practice? How (or why) did you select me? What expectations do you have of me?

One effective way to approach patient counseling is to remember the acronym BATHE (background, affect, trouble, handling, empathy). This helps you quickly uncover the patient's psychological and behavioral background and the context of the visit.

“Nine Ways to Conduct More Efficient Office Visits,” May 1997, p. 83.

Try to address the patient's priorities first, but let the patient know you also have an agenda.

To improve communication with patients, even in brief encounters, start by asking questions that explore not only the presenting problem but other background issues that might affect your diagnosis and treatment.

“Are Poor Nonverbal Skills Slowing You Down?” September 1997, p. 90.

Since you communicate 55 percent of the time without ever saying a word, pay attention to what your nonver-bal signals are saying to patients.

A few simple strategies to improve your practice's image can lead to greater patient satisfaction. For example, if you give your patient your undivided attention for the first 60 seconds, he or she will perceive the visit as worthwhile.

One of the best things you can do for a new patient is to prepare a first-visit handout that describes your practice philosophy, tells what patients can expect during the first exam and offers a brief biography of each physician.

Patient-centered care

“Managing Diversity: The Mandate of the '90s,” June 1996, p. 30.

A physician's insensitivity to cultural differences can jeopardize the quality of patient care. Heightened self-awareness is the first step in becoming culturally competent.

Educating patients about their diseases and treatment plans is a must if you want them to follow through with medication, new diets and lifestyle changes. The best results, however, come when you combine education with behavior modification and emotional support.

Referrals

Be sure you fully explain to patients why you are sending them to a consultant and when you expect to see them back in your office. Develop a system for reminding yourself when to make follow-up calls to patients you refer.

Scheduling

“A Checklist for Scheduling Success,” January 1995, p. 68.

No system, no matter how well designed, can substitute for good, old-fashioned customer service and the personal touch.

“A Method for Decreasing Missed Appointments,” February 1997, p. 77.

The number of missed appointments your practice logs each week may surprise you. Creating a patient reminder system can help you minimize them.

Telephone communication

“Are Your Phones Patient Friendly?” May 1996, p. 66.

Increase the effectiveness of your phone service by improving your staff's phone skills, testing your answering service, conducting a phone availability study and educating patients while they are on hold.

“How the Telephone Can Transform Your Practice,” October 1996, p. 56.

Using the telephone proactively, you can improve patients' access to care, spend more time with patients who really need you and boost patient satisfaction.

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